Last updated: October 15, 2026
If you're in your 40s or 50s and noticing changes in your weight or body shape, even though your eating and exercise habits haven't changed much, you're likely not imagining things.
One of the most common conversations I have with women navigating perimenopause and menopause is about how their bodies are changing, particularly around the midsection.
The reality is that hormonal changes can affect body composition, but they're only part of the picture.
Why does body composition change during menopause?
As estrogen levels decline during the menopause transition, women tend to experience a shift in where their bodies store fat, with more fat accumulating around the abdomen, including visceral fat (the fat stored deeper around our internal organs).
At the same time, several other changes may be happening:
Muscle mass: We naturally tend to lose muscle as we age, particularly if we're not regularly challenging our muscles through strength training.
Sleep: Night sweats, disrupted sleep, and insomnia can affect energy, appetite regulation, and our ability to maintain healthy routines.
Physical activity: Changes in energy, lifestyle demands, and recovery may mean we're moving less throughout the day without necessarily realizing it.
Stress and mood: Increased stress, mood changes, and competing responsibilities can influence eating patterns, sleep, and consistency with health behaviours.
These factors often overlap, which helps explain why strategies that worked in your 20s or 30s may no longer produce the same results.
It's also important to recognize that changes in body composition don't always show up on the scale. You may notice your waistline changing even when your weight hasn't changed significantly.
What can you do about menopause-related weight gain?
When a woman comes to see me because she's struggling with her weight during perimenopause or menopause, I don't start by handing her a diet plan.
I start by trying to understand what's happening in her body and her life.
Here are three important areas I explore:
1. Understand your metabolic health
Depending on your health history and symptoms, blood work may help identify factors that could be contributing to weight-management challenges or affecting your long-term health.
This might include evaluating thyroid function, blood sugar regulation, cholesterol levels, and other relevant markers.
We also look at your weight history, other health concerns, medications, and previous approaches to weight management.
The goal isn't to assume there's a hormonal imbalance that needs fixing. It's to understand your overall health and identify what deserves attention.
2. Look at how you're nourishing and moving your body
Nutrition matters, but it's about more than simply eating fewer calories.
I look at eating patterns, protein and fibre intake, meal timing, hunger and fullness cues, and whether you're getting enough nourishment to support your activity levels and goals.
Movement is equally important, particularly strength training.
Maintaining and building muscle supports strength, physical function, metabolic health, and healthy aging. When we're working toward fat loss, preserving muscle is an important part of the conversation.
3. Identify what's making progress more difficult
Sometimes the biggest barriers aren't related to food or exercise at all.
Poor sleep, persistent fatigue, high stress, mood changes, and an overwhelming schedule can all make it harder to implement and maintain healthy habits.
Rather than assuming you need more discipline, I want to understand what's getting in your way.
It's not just about losing weight
For many women, the goal is to feel more comfortable in their bodies. That's a perfectly valid reason to seek support.
At the same time, I encourage women to think beyond the number on the scale.
We want to consider what kind of weight is being lost, how muscle and strength are being supported, and whether the changes you're making are improving your energy, metabolic health, and quality of life.
The goal isn't simply to weigh less. It's to come out of the process healthier, stronger, and better equipped to maintain your progress.
An individualized approach to weight management
This is the philosophy behind The Metabolic Method™, my approach to helping women navigate weight and body-composition changes, particularly through midlife.
Rather than following a predetermined diet or program, we begin with a thorough assessment, identify the factors that matter most, and build a strategy around your needs, priorities, and goals.
For some women, the initial focus may be improving sleep, nutrition, or metabolic health before actively pursuing weight loss. For others, we may be ready to work toward body-composition changes while protecting muscle and strength.
There isn't one right starting point for everyone.
You shouldn't have to fit yourself into a program. The approach should fit you.
Looking for support?
If you're navigating perimenopause or menopause and feeling frustrated by changes in your weight or body composition, I'd be happy to help you explore your options.
I offer individualized naturopathic care for women navigating hormonal and metabolic health changes, including weight management.
Book a complimentary 15-minute discovery call to learn more about my approach and whether working together may be a good fit.
Dr. Andrea Gri, ND, MSCP
Naturopathic Doctor | Menopause Society Certified Practitioner
References:
Greendale, G. A., Sternfeld, B., Huang, M., Han, W., Karvonen-Gutierrez, C., Ruppert, K., Cauley, J. A., Finkelstein, J. S., Jiang, S.-F., & Karlamangla, A. S. (n.d.). Changes in body composition and weight during the menopause transition. JCI Insight, 4(5).
https://doi.org/10.1172/jci.insight.124865
Santen, R. J., Allred, D. C., Ardoin, S. P., Archer, D. F., Boyd, N., Braunstein, G. D., Burger, H. G., Colditz, G. A., Davis, S. R., Gambacciani, M., Gower, B. A., Henderson, V. W., Jarjour, W. N., Karas, R. H., Kleerekoper, M., Lobo, R. A., Manson, J. E., Marsden, J., Martin, K. A., … Endocrine Society. (2010). Postmenopausal hormone therapy: An Endocrine Society scientific statement. The Journal of Clinical Endocrinology and Metabolism, 95(7 Suppl 1), s1–s66. https://doi.org/10.1210/jc.2009-2509
Williams, L. T., Collins, C. E., Morgan, P. J., & Hollis, J. L. (2019). Maintaining the Outcomes of a Successful Weight Gain Prevention Intervention in Mid-Age Women: Two Year Results from the 40-Something Randomized Control Trial. Nutrients, 11(5). https://doi.org/10.3390/nu11051100
Williams, L. T., Hollis, J. L., Collins, C. E., & Morgan, P. J. (2013). The 40-Something randomized controlled trial to prevent weight gain in mid-age women. BMC Public Health, 13, 1007. https://doi.org/10.1186/1471-2458-13-1007
Disclaimer: The information provided on this blog is for educational and informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making any changes to your health regimen. The content shared here is based on the author’s research and personal experiences, and individual results may vary. The author and blog are not responsible for any adverse effects or consequences resulting from the use of any suggestions, preparations, or procedures discussed on this site.